title: Blood glucose as a predictor of mortality in children admitted to the hospital with febrile illness in Tanzania.
abstract: Data from a prospective study of 3,319 children ages 2 months to 5 years admitted with febrile illness to a Tanzanian district hospital were analyzed to determine the relationship of blood glucose and mortality. Hypoglycemia (blood sugar < 2.5 mmol/L and < 45 mg/dL) was found in 105 of 3,319 (3.2%) children at admission, and low-normal blood glucose (2.5-5 mmol/L and 45-90 mg/dL) was found in 773 of 3,319 (23.3%) children. Mortality was inversely related to admission blood sugar; compared with children with an admission blood glucose of > 5 mmol/L, the adjusted odds of dying were 3.3 (95% confidence interval = 2.1-5.2) and 9.8 (95% confidence interval = 5.1-19.0) among children with admission blood glucose 2.5-5 and < 2.5 mmol/L, respectively. Receiver operating characteristic (ROC) analysis suggested an optimal cutoff for admission blood sugar of < 5 mmol/L in predicting mortality (sensitivity = 57.7%, specificity = 75.2%). A cutoff for admission blood glucose of < 5 mmol/L represents a simple and clinically useful predictor of mortality in children admitted with severe febrile illness to hospital in resource-poor settings.
authors.forename: Behzad
authors.initials: B
authors.lastname: Nadjm
authors.forename: George
authors.initials: G
authors.lastname: Mtove
authors.forename: Ben
authors.initials: B
authors.lastname: Amos
authors.forename: Helena
authors.initials: H
authors.lastname: Hildenwall
authors.forename: Anne
authors.initials: A
authors.lastname: Najjuka
authors.forename: Frank
authors.initials: F
authors.lastname: Mtei
authors.forename: Jim
authors.initials: J
authors.lastname: Todd
authors.forename: Hugh
authors.initials: H
authors.lastname: Reyburn
mesh_terms: D001786:Blood Glucose; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000097:blood*; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D007223:Infant; D016778:Malaria, Falciparum / Q000097:blood* / Q000453:epidemiology / Q000401:mortality*; D008297:Male; D011446:Prospective Studies; D012372:ROC Curve; D013636:Tanzania / Q000453:epidemiology
chemical_list: D001786:Blood Glucose